Chapter 12: The Lungs (Part 1) Flashcards
What is the normal amount of breaths we take per minute?
12-20 breaths
If we take in less than 12 breaths per minute, this condition is known as?
bradypnea
If we take in more than 20 breaths per minute, this condition is known as?
tachypnea
How many lobes are in the right lung? left lung?
Right= 3 Left= 2
What two respiratory structures are found in the acinus?
alveolar duct and alveoli
Respiratory pathologies involve what three structures?
Airways, Vasculature, Interstitium
Which type of pneumocyte makes up 95% of the surface of the lungs ?
Type I Pneumocyte
What is the role of type II pneumocytes?
surfactant and repair
What is the medical term for a collapsed lung?
Atelectasis
What causes atelectasis?
collapse of multiple alveoli which causes a decrease in lung volume.
Atelectasis is involved with deoxygenated blood which can create ____ ______.
tissue hypoxia
What are the three types of atelectasis?
Resorption, Compression, Contraction
Resorption Atelectasis is caused by:
a) Airway obstruction
b) Mechanically collapsed Lung
c) scarring of the lungs
a) airway obstruction
What are the two main causes of resorption atelectasis (airway obstruction)?
Mucopurulent plug
or
Tumor, foreing body, surgical fibrosis
What are some examples of mucopurulent plugs that can lead to resorption atelectasis
asthma, CF, chronic bronchitis, bronchiectasis
How is area of collapse determined in resorption atelectasis?
location of obstruction ( can either be single lobe or entire lung)
Compression Atelectasis is caused by:
a) Airway obstruction
b) Mechanically collapsed Lung
c) scarring of the lungs
b) mechanically collapse lung
What leads to the mechanically collapsed lung in compression atelectasis?
something filling the pleural cavity; either blood, tumor or air
What is the most common cause of pleural effusion?
Congestive Heart Failure (CHF)
What is pleural effusion?
fluid around the lungs
Besides CHF, what else can cause pleural effusion?
edmea and blood
Name the condition: Air enters the pleural cavity
Pneumothorax
Contraction Atelectasis is caused by:
a) Airway obstruction
b) Mechanically collapsed Lung
c) scarring of the lung
c) scarring of the lungs
What two types of scarring can cause contraction atelectasis?
1) Interstitial fibrosis
2) Pleural Fibrosis
What is the mechanism by which contraction atelectasis occurs?
Scarring causes decreased expansion of lungs, which limits alveolar opening which causes collapse
Which type of Atelectasis has the most limited recovery:
1) Compression Atelectasis
2) Contraction Atelectasis
3) Resorption Atelectasis
2) Contraction Atelectasis
Which vascular damage is associated with Acute Respiratory Distress Syndrome?
Diffuse Alveolar Damage (D.A.D.)
Which type of epithelial damage is associated with acute respiratory distress Syndrome?
hyaline membrane is pink
What causes hypoxia to occur when you have Acute Respiratory Distress Syndrome?
Trauma prevents gas exchange which causes hypoxemia which leads to hypoxia.
Which tissues are most likely to be impacted by hypoxia?
CNS, heart, kidneys
What is the prognosis for Acute Respiratory Distress Syndrome?
rapid onset, life-threatening; if they survive, prolonged recovery (6-12 months)
What respiratory sign is characteristic of obstructive lung diseases?
wheezing (aka airflow resistance)
What are the four main obstructive lung diseases studied in class?
Emphysema, chornic bronchitis, bronchiectasis, and asthma
What two obstructive lung diseases make up COPD?
Emphysema and chronic bronchitis
A decrease in lung expansion will lead to what lung disease?
Restrictive Diseases
What are the two types of restrictive lung diseases mentioned in class?
1) Interstitial lung diseases (fibrosis)
2) Chest Wall Disorders
What obstructive lung disease is associated with the destruction of the alveolar septa?
Emphysema
What happens to the acini in emphysema?
they enlarge
What causes dyspnea in patients with emphysema?
There is decreased surface area= decreased gas exchange= dyspnea
Can the acini heal in patients with emphysema?
no
What are the two major causes of inflammation in emphysema?
1) Increase in proteases and decrease in anti-proteases
2) Increase in ROS
How is emphysema diagnosed?
Based on the destructive morphology of the alveolar septa
What causes the damage of the alveolar septa in emphysema patients?
Incoming WBC’s (neutrophils, macrophages and lymphocytes)
What is a major risk for emphysema?
Smoking
Why is smoking a major risk for emphysema?
Smoke increases ROS and causes a oxidant-antioxidant imbalance
Long- term emphysema can lead to:
progressive dyspnea, wheezing, and coughing; forced expiration, hyperventilation, and weight loss
What is the name of the appearance given to patiens with long-term emphysema?
Pink Puffer
What are the two types of Emphysema?
Centriacinar and Panacinar
Which type of Emphysema is most common: Centriacinar or Panacinar?
Centriacinar
Which type of Emphysema destroys the central acinus?
Centriacinar
What is the most common location of centriacinar emphysema?
Apices of lungs
What is a major risk factor of centriacinar emphysema?
smoking
What type of emphysema has the acinus uniformly destroyed?
Panacinar
What is the most common location of panacinar emphysema?
lower lung fields
Patients with Panacinar emphysema are deficient in what enzyme?
Alpha1-antitrypsin
What affect does smoking have on panacinar emphysema?
accelerates destruction
Hypersecretion of mucus is seen in what respiratory condition?
Chronic bronchitis
What causes the hypersecretion of mucus in chronic bronchitis?
increased sputum production due to the hypertrophy and hyperplasia of mucous glands
What are the risk factors for chronic bronchitis?
smoking, air pollutants, Males aged 40-65
What conditions must be met to be diagnosed with Chronic bronchitis?
persistent productive cough lasting more than 3 consecutive months in more than 2 consecutive years
What signs and symptoms are present in patients with Chronic Bronchitis?
Dyspnea, wheezing, cyanosis, weight gain; possible cor pulmonale
What is the name of the appearance given to Chronic bronchitis patients?
blue bloater
Are recurrent infections common in chronic bronchitis cases?
yes
IF chronic bronchitis coincides with emphysema, this condition is known as:
Chronic Obstructive Pulmonary Disease COPD
What is unique about the airflow obstruction in COPD?
Irreversible Airflow
What can happen as a result of irreversible airflow obstruction?
prominent wheezing
possible pulmonary HTN
What is asthma?
bronchoconstriction which leads to obstruction of the airway
What are the various stimuli for asthma?
smooth muscle hypertrophy and hyperreactivity
Inflammation and increased mucous
Does asthma have reversible or irreversible airway obstruction?
reversible
What are the signs and symptoms of asthma?
wheezing, dyspnea, cough, or chest tightness; difficulty inhaling or exhaling
What time is asthma most pronounced?
morning and evenings
What histological features are characteristic of asthma?
Curschmann spirals and charcot-leyden crystals
Which type of asthma is a type I hypersensitivity and caused by allergens?
Atopic Asthma
Which type of asthma is bronchial hyper-responsiveness and causes by various (non-allergic) exposures?
Non-Atopic Asthma
What is the most common form of asthma cases?
Atopic Asthma (70%)
Which type of asthma has a childhood onset with family history and happens with exposure to environmental antigens?
Atopic Asthma
What are examples of Atopy?
eczema/urticaria, allergic rhinitis
How common is non-atopic asthma?
Less common, only 30%
Which type of asthma is characterized by bronchial inflammation and hyper-responsiveness, idiopathic and has no allergen or family history?
Non-Atopic Asthma
What are the various stimuli for non-atopic asthma?
Viral URTI, pneumonia, exercise, cold air, aspirin, inhaled irritants, psychological stress
What is chronic asthma?
prolonged severe wheezing/dyspnea
What causes bronchial narrowing in chronic asthma?
1) hypertrophy of bronchial smooth muscles
2) Fibrosis
3) Increased submucosal glands (mucous plugs)
4) Increased submucosal vascularity
What happens to the acini in chronic bronchitis?
It becomes hyperinflated
What is status asthmaticus?
asthma that does not respond to bronchodilators or steriods
Is status asthmaticus lethal?
Yes, can cause hypoxemia
What is bronchiectasis?
permanent dilation of bronchi due to the destruction of connective tissue and musculature
What diseases can cause obstruction leading to necrotizing infection in bronchiectasis?
Lung Ca, TB, chronic bronchitis, foreign bodies
or
Mucus: asthma, CF
Where is bronchiectasis located in the lungs?
lower lob, could be localized or bilateral
Patients with bronchiectasis can have episodes of severe coughing that can produce what ?
hemoptysis
purulent foul-smelling sputum